Accounts Receivable (A/R) and Denial Management Specialist (athenahealth)

This is a remote position. Job Summary RCM Staff BPO is hiring 2 full-time A/R and Denial Management Specialists to support a U.S. medical billing company that serves multi-specialty physician practices nationwide, with a large provider base in Ohio. The specialist will work claims and denials daily in athenaOne across specialties such as cardiology, orthopedics, podiatry, retina, family medicine, OB/GYN and behavioral health. This role requires solid A/R and denial experience, such as strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans. Key Responsibilities • Work a daily worklist in athenaOne, starting with new denials and payer correspondence, then open A/R prioritized by filing deadline, age and balance • Follow up with payers on unpaid and underpaid claims through payer portals and phone calls • Document claim status, call reference numbers and next steps on every account worked • Review denials, identify the root cause, and correct and resubmit claims • Prepare and submit reconsiderations and appeals, and track them through to a decision • Monitor timely filing and appeal deadlines so claims do not age out • Route coding, authorization and provider enrollment issues to the right team for resolution • Join scheduled meetings with the client team and send a daily end-of-shift summary of completed work and open items • Protect patient information and follow HIPAA requirements Qualifications • At least 3 years of U.S. medical billing experience, focused on A/R follow-up and denial management • Hands-on experience working claims and denials in athenahealth ( athenaOne ) • Experience preparing and submitting appeals and reconsiderations • Familiarity with commercial insurance and government health plans, such as Medicare and Medicaid • Comfortable calling insurance companies and using payer portals for claim follow-up • Strong written and spoken English • Excellent attention to detail and follow-up skills • Ability to work independently and manage a high volume of accounts • Reliable internet connection and a suitable remote workspace Preferred Qualifications • Experience working for a U.S. medical billing company that supports multiple client practices • Multi-specialty billing experience, especially cardiology, orthopedics, podiatry, ophthalmology/retina, OB/GYN or behavioral health • Familiarity with Ohio payers, including Ohio Medicaid managed care plans • Experience with Medicare Advantage plans and aged A/R cleanup projects Schedule • Full-time position • Must be available for hours that overlap U.S. Eastern Time business hours (night shift, Philippine time) for meetings, real-time communication and payer calls • Final schedule will be determined based on client needs Work Arrangement • Remote • Philippines-based applicants preferred Originally posted on Himalayas